Arthritis, especially when it affects children, can result in having to say “no” to many things. Just getting out of bed can be difficult, let alone the challenges of working with big insurance or pharmaceutical companies to gain access to care that’s needed to manage the disease. The Arthritis Foundation is helping to increase the number of everyday successes and achieve big victories in the lives of those with arthritis.
Recently, after a three-year-long fight, Zane Breier, who suffers from scleroderma morphea, a disease which causes skin discoloration and difficulty with joint and muscle function, achieved one of these victories. When his condition rapidly declined and spread to affect more areas of his body, even plastic surgery became a consideration, as Zane’s face, tongue and eyes were affected by his disease. He had to have gum grafts, and he and his family began to lose hope. The fight became tiring and the obstacles felt insurmountable.
Zane’s doctor, a pediatric rheumatologist, prescribed Orencia for Zane to help slow the progression of his disease, but he was denied coverage. His family of five could not afford to pay for a year or more of treatment. However, through the efforts of the Arthritis Foundation, the family was able to tap into other resources for help. Together, they worked with Zane’s hospital and directly with his insurance provider to show how the medication would benefit Zane, yet the rejections continued.
There was a breakthrough, however, when Zane was asked to speak on behalf of the Arthritis Foundation at an event for CVS/specialty, a division of CVS Health. In response to Zane’s trials and tribulations in getting the care he needed, CVS/specialty worked with the pharmaceutical company to get the needed medication. When Zane was told that the infusion was finally going to happen, his first reply was “Yes!” As his mother puts it, the response was “so loud you would have thought he’d just won a million dollars.”
Zane’s case is not unique. There are thousands, if not millions, of people with arthritis who face similar circumstances and denials to coverage on a daily basis. To help people with arthritis here in San Diego and across the country, the Arthritis Foundation is fighting for more “yes” moments that result in both big victories like Zane’s and the thousands of small victories won every day for those battling arthritis.
For more information visit: www.arthritis.org